MAGIC OF THE SURGEON.

Manawatu Standard, Volume XLI, Issue 10526, 2 December 1916, Page 10

MAGIC OF THE SURGEON.

; MAKING NEW MEN OF OLD. ! LONDON, Aug-. 14. ' The marvellous progress that has been made in recent times in surgical science is most impressively revealed by a journey to some of the larger military hospitals, made ' possible through the courtesy of Sir Alfred 1 Keogh. Director-General of the Army Med- ■ ical Si rvice. In all the hospital:: what the medical staff ' set :i .jve all is conservative surgery—that is to say, the caving of limbs in order that I the p-.tiente may remain useful members 01 | r he community. Thus, at the Herbert Hosj pital, at Shooter's Hill, there have been since the beginning of the war from three i to four thousand operations, and Colonel Simpson, the officer in charge, declared that ho did not believe there had been in al! more than twenty-five primary amputations. The impression left by a tour o*' those hospitals upon the layman's mind is that outsiders have an utterly inadequate idea of the debt they owe to modern surgery at atime like the'present, Day by day the surgeons are giving to the nation new men for old. They have embarked upon a greatmission of hope among the nation's soldiers. They are doing more than would have been credible twenty years ago to rob war of its ultimate horror. Out of the hundreds of wonderful cases brought, to one's notice during these visits it is onlv possible to describe a few that may be regarded as typical of this trade of mending soldiers. Take first the new nerve surgery. Here is a man with a bullet hole near his collarbone which severed the nerve controlling the muscles of the wrist. The result was "wrist-drop" and a hand winch until quite recently would have been, regarded as uncurably useless. The two ends of the severed nerve have been freed from what had already become no more than a rear, and there is everyp rospeet thatm less than a year ,he hand will be almost as good as ever. ■ "As simple as tying up two ends ol a cut Vlephone wire," says the surgeon who operated. There are more remarkable cases still. A man had part, of the fleshy part of his arm .Trot away carrying with it four inches o the nerve necessary to control the hand movements The surgeon rang up several hospitals (ill he heard of whet he "anted, the amputation (hat, afternoon ol a healthy limb. The limb happened to be a leg, ami it was amputated in the afternoon. No ■ ooner was it cut off than four or live inches of practically living nerve were removed from the calf, placed in a saline bath and rushed by taxi to the other hospital. Hero -he patient was already under an aneas* bene The wound in his arm was opened with a lancet, the ends of the indispensable nerve quickly found and the circuit /-established, •s it were I>a means of the first patient s 'four inches of filament,. To-day the man is in a fair way of regaining the full use ol his hand. . ~ ~ • Bone ,urgerv on rather similar line, i» more familiar, but hardly less surprising when you meet and talk to a man who conversesVith the aid of a lower jar part ■vhich onlv a few weeks ago part of his ,;"."( I,- ' It was mended with two and one half inches of one of his shin bones The skin was quite healed, and the hole Will incompletely' filled with new bone befene ] on o-, so accommodating is Marine wnen treated with knowledge. Another patient, is perfectly happy *™ ~ro«iMvou-i with three inches ol the ngula fffie?t leg neatly mortised in the lamerright arm. He too. will finaAl ,„tter no loss of bone whatever. The :.nts of such,operations are endless and only limited by the ingenuity and enterprise ot each surgeon. CARPENTRY AND LEGS. Of remarkable examples of carpentry applied to broken limbs most hospitals have ,vo or three if not more, en hand. A young fellow was brought into the hospital with one to- shortened by five inches, owing lO the ends of the broken bone overlapping. He seemed a hopeless cripple. Ihe leg as rebroken under an anaesthetic an eighth of an inch cut off from each side ol the fracture so as to secure a smooth joint, and a steel plate fastened on with six screws precist ly as one would mend the broken leg of a tabic. The plate and screws will remain in position as a permanent addition to die soldier's anatomy, for steel wii not rust among the tissues. And the man has a leg practically as long and a.s straight as and rather stronger than it was intended to be ay Some U of'the most cruel wounds are those in the jaw, but even here what the skill ana patience, of the surgeon have been able to do is wcr.derful. One poor fellow who had been provided with a new root to his mouth was one of the most cheerful of the patients. His comic songs are the delight of the ward. You cease to be amazed at any height of human skill or hums i age after a few hours m any 01 these military hospitals. You know lor certain -e.n that man is unconquerable. When the injury is to the upper par, ot the face, resulting in, say, the removal ot Tie nose and one eye, magical results are being achieved in a south-western district district hospital by the provision ot masks perfactly counterfeiting the lost section ol the physiognomy. Lieutenant. Convent Wood is Tie inventor of the plan. With the help of photographs of what a. patient was like before being wounded he will make a false nose of silvered copper, artistically painted to match the surrounding complexionion, which will so far defy detection as to enable the owner to go out into the world again without shrinking and play his old part" in the affairs of men. A REMARKABLE OPERATION. Here is another remarkable case. Not long ago a wounded Guardsman was brought into the Queen Alexandra Hospital, at Milbank, suffering from a shrapnel wound. Examination under the X-rays showed that a piece of metal as largo as a half-penny and much ibicker had entered the breast and lodged in the region of the heart. It was, in fact, actually touching the heart and impeding its action. An operation was decided on, and the surgeon thrust his hand right into the opening and pulled out the piece of metal, which is preserved as a souvenir. There was a j danger that during anaesthesia Ihe lungs would collapse, and therefore ether was pumped into them to keep them, distended That gallant Guardsman is now out and about, and it is declared that he will not feel the slightest ill effects from his strange experience. ' In this hospital there is at present a Serbian officer who was wounded in his own country and brought to England for treatment. It was a case of severe injury to the jaw. Lieutenant Sir Francis Farmer removed a piece- of bone about 2J.in long from the tigia'of the patient, and. having carefully prepared a bed in which to place it, fixed it in the jaw. The leg is now healed, and the patient can eat wonderfully well. But this refitting, and, as it were, rebuilding of citizenis s not enough. ihey must first be snatched from that progressive process of dectruction associated with ihat dreaded word sepsis, that creeping death of the tissues which is the surgeon s most remorseless enemy. And here again one encounters the marvellous. "GAS GANGRENE." In this war the variety of sepsis that has claimed more victims than any other is that known in doctors' slang as "gas gangrene." Gas gangrene is caused by the presence in a wound of bacilli classed as •'anaerobic," that is, bacilli which cannot live in air, the vital principle oi which is oxygen. They exist—like the tetanus bacilli-—ir cultivated soil, and it is because the war is being fought in France among the peasants' fields that they are introduced so constantly by ricocheting bullets or scraps of earth-stained clothing into the soldiers' wounds. . Once there they set about producing tiny gas bubbles among the tissues hence the name "gas gangrene." But the gas, thev cannot endure is oxygen, and the ob- | vi( us way to destroy them is to introduce oxygen into the innermost recesses of the wound. This is secured by various methods according to the nature of the injury. A hole right through the shoulder will _be sterilised by the use of a wick drawing j peroxide of hydrogen from a small tank above the bed. Another kind of wound I may be sprayed with ozone, and the third more convenientlly dealt with by means] of a perforated tube fed with oxygen gas from a cylinder. ! The operations to which reference has been made would doubtless be described its severe even by the surgeons themselves; nevertheless modern science has m robbed thcnl of most of their terrors. The im- j provements in anaesthetics have been such t! at it is no uncommon thing tor an op- ' oration to last two hours and for the patent to f< el ho iH effects from the drug a quarter of an hour after he recovers consciousness. Some, indeed, will be smoking a cigarette within that space ot Time. The secret lies in the administra-. tion of cxyge'ii with' the anaesthetic.